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OBJECTIVE: The aim of this study was to establish the prevalence of hepatitis C virus infection in different populations at risk for infection. METHODS: This was a descriptive, transversal study whose variables were evaluated by Pearson s correlation analysis. Different populations were selected: 100 drug users, 47 sex workers, and 50 hemodialysis patients for a total of 197 individuals. The only inclusion criterion was the apparent risk of acquiring this viral infection. The presence of antibodies against virus was examined by ELISA IV (Innotest HCV Ab IV). Reactive samples were then tested using a recombinant assay (INNO-LIA HCV Ab III), both from Innogenetics N. V. (Belgium). The presence of viral RNA was determined in all ELISA and immunoblot-reactive samples by a nested polymerase chain reaction method (HCV-fast of Pharma Gen). RESULTS: A prevalence of 1% was found in drug users, and absence of infection or previous contact with the virus in sex workers and hemodialysis patients. CONCLUSIONS: This study shows a very low prevalence of infection with hepatitis C virus in populations at risk for acquiring the infection, and considered that this infection is not a public health problem in these populations in Maracaibo, Venezuela.

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El personal de enfermería desempeña una actividad fundamental en los servicios de salud, con fuerte apego a principios científicos y éticos; sus intervenciones permiten fortalecer la calidad en los servicios de salud, através de acciones interdisciplinarias. Se analizaron las inconformidades relacionadas con atención de enfermería que recibió la Comisión Nacional de Arbitraje Médico (CONAMED) de junio de 1996 a diciembre de 2001. Con base en el análisis se elaboraron recomendaciones dirigidas a prevenir el conflicto, mejorar la práctica de enfermería y propiciar la adecuada comunicación con el paciente, familiares y equipo interprofesional de salud. Se integró un grupo representativo de las instituciones educativas y gremiales de enfermería más prestigiadas y reconocidas, para su validación externa. De esta manera, la CONAMED y el grupo de validación externa, proponen al personal de enfermería atender las siguientes recomendaciones: 1) Mantener una comunicación efectiva con las personas a las que proporciona atención; 2) Reconocer en la persona su concepción holística; 3) Proporcionar cuidados que garanticen la atención libre de riesgos y daños innecesarios; 4) Establecer una coordinación efectiva con el equipo interprofesional de salud; 5) Actuar con base en los principios éticos que rigen la práctica profesional de enfermería.

Nurse personnel performs a fundamental activity in t health services, with strong attach at scientific and ethical principles, whose interventions can fortify the services of health quality, through interdisciplinary actions. We analyzed the compliants related to nursing attention that were received in CONAMED since June 1996 to December 2001. Wedevised recommendations directed to prevent patient-health care professionals conflicts, improve the practice of nursing and favor adequate communication with the patient, family and interprofessional health care team. Those recommendations were presented to the more prestigious and recognized educational and professional groups of nursing, for their external validation. In this manner, CONAMED and the external group of validation, propose to nurses to attend the following recommendations: 1) Maintain an effective communication with the patients that provides attention; 2) Recognize the holistic concept in the person; 3) Provide cares that guarantee tree-risk attention and prevent unnecessary damages; 4) Establish an effective coordination with the health care interprofessional team and 5) Act based on ethical principles that govern the professional practice of nursing.

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Influence of environment and lactation patterns on amenorrhea duration and frequency of ovulation before the first menstrual bleeding postpartum are studied on a group of 100 women (half rural, half from urban areas). All subjects studied were highly motivated to breastfeed for prolonged periods. Results show a more prolonged amenorrhea, although not statistically significant, in those women from the rural zone. Ovulation frequency before the first vaginal bleeding was 14% none ovulated before six months.

PIP: 100 women in Yucatan, Mexico, participated in a longitudinal and prospective study of the influence of lactation patterns and rural or urban residence on the duration of amenorrhea and the frequency of ovulation before the first postpartum menstrual period. 50 women from the city of Merida and 50 from nearby villages were followed until their first postpartum menstruation. The women were of lower socioeconomic status and aged 20-31 years. All had breast fed at least two older children and none used contraception before the first postpartum menstruation. 25 women in each residence group practiced exclusive breast feeding in the first months and 25 mixed bottle and breast feeding. The women kept records of the number of nursing episodes or bottles given, and collected 24-hour urine samples weekly beginning in the fourth postpartum month for urinary pregnanediol determination. Monthly blood samples were obtained before and after nursing to measure prolactin levels. Ten of the 100 women withdrew before completion of the study. The women in all four subgroups were very similar in age, education, and family size. The average duration of amenorrhea was 10.58 months for the 49 rural women and 8.02 months for the 44 urban women, but the difference was not statistically significant. The 11.02 month duration of amenorrhea of the exclusively breast feeding mothers was significantly longer than the 7.34 months of the partially breast feeding group. At six months postpartum, nine exclusively breast feeding and 22 partially breast feeding mothers had resumed menstruation. 75 of the women (88.3%) resumed menstruation within one year. 13 women (14.4%) ovulated before the first menstruation, with an average duration of amenorrhea of 9.8 months. None of the women became pregnant before the first menstruation. Prolactin levels were significantly lower in the women who ovulated before the first menstruation.

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The molecular karyotype of 3 clones derived from strain HM1:IMSS of Entamoeba histolytica was studied by transverse alternating field electrophoresis. 11-20 bands ranging between 0.3 and over 3 Mb were resolved. Hybridization with total DNA detected highly repetitive sequences in the slow-migrating molecules, while non-repetitive sequences were located in the intermediate and fast-migrating molecules. rDNA, tubulin, actin, cysteine proteases DNA fragments, and a variable DNA sequence (EhVR1) located the respective genes mainly in the 1.3-1.5-Mb region, although they differed in the three clones. Two-dimensional transverse alternating field electrophoresis showed that more than one high-molecular weight molecule may comigrate in a single DNA band. rDNA, and EhVR1 hybridized with slow-migrating bands in a characteristic ladder pattern. Most of the bands recognized by EhVR1 seems to be linear molecules, although exonuclease III-resistant bands also hybridized with EhVR1, suggesting the presence of circles.

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A comparative clinical trial of two combined oral contraceptives differing only in estrogen type and dosage was conducted at the Centro de Investigaciones Hideyo Noguchi in Merida, Yucatan, Mexico. The trial was designed to determine the differences between Norinyl 1 + 50 (Syntex) and Norinyl 1 + 35 (Syntex) in rates of discontinuation and frequency of selected side-effects which might contribute to method discontinuation. Three hundred women were randomly assigned to either the Norinyl 1 + 35 group or to the Norinyl 1 + 50 group and follow-up visits were scheduled at 1, 4, 8 and 12 months after admission. In the Norinyl 1 + 35 group, more women experienced an increase in intermenstrual bleeding (primarily staining and spotting) (p less than 0.05), breast discomfort (p less than 0.05) and nausea than in the Norinyl 1 + 50 group. There was a significantly higher discontinuation rate for personal reasons, such as desired change of method and method not needed, among the women taking Norinyl 1 + 35 (p less than 0.05). The largest number of discontinuations comprised women discontinuing for menstrual problems in both groups. The life-table total discontinuation rate at 12 months was 52.0 for the Norinyl 1 + 35 group and 50.7 for the Norinyl 1 + 50 group. The lost-to-follow-up rates at 12 months were 17.8 for the Norinyl 1 + 35 group and 22.8 for the Norinyl 1 + 50 group.

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The prevention of HIV infection in school and university communities acquires great importance in adolescents and young adults where the risk of HIV infection is caused by age, occupation, location, and also adjoining relations with other groups of high incidence of infection, such as teachers and administrative employees. Adequate strategies for specific groups are needed. This paper focuses on the strategies developed at the National Autonomous University of Mexico. An interdisciplinary health commission for the prevention and control of AIDS was established to inform the student body. Other activities performed by this commission include providing medical and psychological attention for AIDS victims, as well as detecting and carrying out follow-up studies of infected students. Efforts in health education have also been made by training professors to include preventive measures against this disease as part of their subject matter. Specific, organized, and immediate action must be taken by health personnel and community organizations in order to prevent HIV infection in adolescents and young adults.

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El objetivo del presente estudio, fue evaluar "in vivo" la acción de los antiácidos y de los antagonistas de los receptores H2, sobre el pH gástrico, en pacientes portadores de ulceras gástricas y duodenales, con el fin de establecer cual es la medicación más efectiva. Se estudiaron 16 pacientes ulcerosos: nueve eran portadores de Ulcera Duodenal, dos tenían Ulcera Gástrica y cinco presentaban Ulcera Gástrica y Duodenal. En cada paciente se obtuvo el contenido gástrico por aspiración mediante una sonda nasogástrica, en forma horaria desde la hora 8 a la hora 20; midiéndose la secreción nocturna por aspiración a la hora 8 del día siguiente, estando el paciente en ayunas y sin medicación. El mismo procedimiento se repitó en cada paciente administrando Cimetidina (a la dosis de 1 g. por día), Ranitidina (a la dosis de 300 mg. por día), Hidróxido de Aluminio y Magnesio (a la dosis de 150 ml por día) y finalmente se repitió el procedimiento asociando la Ranitidina con el Hidróxido de Aluminio y Magnesio en las dosis anteriormente mencionadas. Se realizó un análisis estadístico de los resultados, calculándose la ordenada media de pH. El efecto medio del tratamiento se obtuvo promediando las diferencias individuales (pH tratamiento - pH sin tratamiento). El mismo procedimiento se empleó para la comparación de los diferentes fármacos entre sí. Se realizaron pruebas de Student para muestras dependientes con un nivel de significación de alfa = 5%. La capacidad de neutralización se midió por la proporción del total de muestras con un pH igual o mayor a 4, obtenidos en cada tratamiento y en el total de pacientes, comparándose con los resultados hallados sin medicación. Se utilizó el x2 con corrección de Yates. Todas las medicaciones fueron eficaces (aunque en diferente grado) para neutralizar la acidez gástrica. La combinación del antiácido con la Ranitidina apareció como lo más eficaz, mostrando diferencias estadísticamente significativas con la Cimetidina y el Hidróxido de Aluminio, y Magnesio, no así con la Ranitidina sola

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El objetivo del presente estudio, fue evaluar "in vivo" la acción de los antiácidos y de los antagonistas de los receptores H2, sobre el pH gástrico, en pacientes portadores de ulceras gástricas y duodenales, con el fin de establecer cual es la medicación más efectiva. Se estudiaron 16 pacientes ulcerosos: nueve eran portadores de Ulcera Duodenal, dos tenían Ulcera Gástrica y cinco presentaban Ulcera Gástrica y Duodenal. En cada paciente se obtuvo el contenido gástrico por aspiración mediante una sonda nasogástrica, en forma horaria desde la hora 8 a la hora 20; midiéndose la secreción nocturna por aspiración a la hora 8 del día siguiente, estando el paciente en ayunas y sin medicación. El mismo procedimiento se repitó en cada paciente administrando Cimetidina (a la dosis de 1 g. por día), Ranitidina (a la dosis de 300 mg. por día), Hidróxido de Aluminio y Magnesio (a la dosis de 150 ml por día) y finalmente se repitió el procedimiento asociando la Ranitidina con el Hidróxido de Aluminio y Magnesio en las dosis anteriormente mencionadas. Se realizó un análisis estadístico de los resultados, calculándose la ordenada media de pH. El efecto medio del tratamiento se obtuvo promediando las diferencias individuales (pH tratamiento - pH sin tratamiento). El mismo procedimiento se empleó para la comparación de los diferentes fármacos entre sí. Se realizaron pruebas de Student para muestras dependientes con un nivel de significación de alfa = 5%. La capacidad de neutralización se midió por la proporción del total de muestras con un pH igual o mayor a 4, obtenidos en cada tratamiento y en el total de pacientes, comparándose con los resultados hallados sin medicación. Se utilizó el x2 con corrección de Yates. Todas las medicaciones fueron eficaces (aunque en diferente grado) para neutralizar la acidez gástrica. La combinación del antiácido con la Ranitidina apareció como lo más eficaz, mostrando diferencias estadísticamente significativas con la Cimetidina y el Hidróxido de Aluminio, y Magnesio, no así con la Ranitidina sola (AU)

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Se presenta una investigación tendiente a aclarar la posible existencia de una relación entre la estructura antígena HLA de un individuo y la eventualidad de que éste desarrolle o no una cirrosis al ingerir alcohol en forma crónica. A estos efectos se integró un equipo multidisciplinario conformado por clínicos, genetistas, psiquiatras y patólogos, integrantes de 4 Cátedras de la Facultad de Medicina. Se diseño un trabajo prospectivo de investigación que se desarrolló en el transcurso de los años 1982 a 1984. Se estudiaron 47 alcoholistas portadores de una Cirrosis Portal, 19 alcoholistas No Cirróticos y 250 testigos sanos. Los cirróticos fueron biopsiados para confirmar histopatológicamente la enfermedad y los alcoholistas no cirróticos fueron biopsiados para confirmar que no la tuvieran. En todos los grupos se determinaron los antígenos de histocompatibilidad indicados en la Tabla I. Se efectuaron los cálculos estadísticos que incluyeron X con corrección de Yates, probabilidad corregida, y el cálculo del riesgo relativo (R.R), (este último especificado en la Tabla II). En el grupo de alcoholistas cirróticos, se comprobó una asociación positiva con el HLA Bw40, con un valor estadístico muy significativo: Pc<0,005; RR=3,93. (Tabla IV). No se comprobó predominancia de este antígeno en los etilistas no cirróticos (Tabla V). Se concluye que la presencia del HLA Bw40 aumenta casi 4 veces el riesgo de desarrollar una cirrosis en los pacientes que ingieren alcohol en forma crónica. Su presencia no influye estadísticamente en nuestra serie en el riesgo de que un individuo se convierta en alcoholista. Esta investigación, de comprobarse en series mayores, que este equipo de trabajo está desarrollando, permitirá en el futuro determinar criterios de prevención de la cirrosis alcohólica

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Se presenta una investigación tendiente a aclarar la posible existencia de una relación entre la estructura antígena HLA de un individuo y la eventualidad de que éste desarrolle o no una cirrosis al ingerir alcohol en forma crónica. A estos efectos se integró un equipo multidisciplinario conformado por clínicos, genetistas, psiquiatras y patólogos, integrantes de 4 Cátedras de la Facultad de Medicina. Se diseño un trabajo prospectivo de investigación que se desarrolló en el transcurso de los años 1982 a 1984. Se estudiaron 47 alcoholistas portadores de una Cirrosis Portal, 19 alcoholistas No Cirróticos y 250 testigos sanos. Los cirróticos fueron biopsiados para confirmar histopatológicamente la enfermedad y los alcoholistas no cirróticos fueron biopsiados para confirmar que no la tuvieran. En todos los grupos se determinaron los antígenos de histocompatibilidad indicados en la Tabla I. Se efectuaron los cálculos estadísticos que incluyeron X con corrección de Yates, probabilidad corregida, y el cálculo del riesgo relativo (R.R), (este último especificado en la Tabla II). En el grupo de alcoholistas cirróticos, se comprobó una asociación positiva con el HLA Bw40, con un valor estadístico muy significativo: Pc<0,005; RR=3,93. (Tabla IV). No se comprobó predominancia de este antígeno en los etilistas no cirróticos (Tabla V). Se concluye que la presencia del HLA Bw40 aumenta casi 4 veces el riesgo de desarrollar una cirrosis en los pacientes que ingieren alcohol en forma crónica. Su presencia no influye estadísticamente en nuestra serie en el riesgo de que un individuo se convierta en alcoholista. Esta investigación, de comprobarse en series mayores, que este equipo de trabajo está desarrollando, permitirá en el futuro determinar criterios de prevención de la cirrosis alcohólica (AU)

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The existence of a relationship between HLA and the possibility of the development of an alcoholic cirrhosis is researched in this paper. This work was done from 1982 to 1984, by the staff of four clinics of the Medicine School of the University of Uruguay. We studied 47 alcoholics with portal cirrhosis, 19 non-cirrhotic alcoholics and 250 healthy nonalcoholic controls. We confirmed with liver biopsy the cirrhosis in the first group and in the second, liver biopsy was performed in order to assure that they had no cirrhosis. Table I shows the histocompatibility antigens which were tested in the 3 groups. Levels of significance were obtained from exact Fisher test with Yates correction for discontinuity; Pc (corrected P) and RR (relative risk) were also determined. In the alcoholics with portal cirrhosis, the HLABW40 showed a Pc less than 0,005 (RR = 3,93). In the non-cirrhotic alcoholics no significative association was found. We conclude that the carrier of the genetic marker HLABW40, has almost 4 times more chances to develop a cirrhosis as consequence of chronic alcoholic abuse. The presence of this marker, in our patients, has no association with the possibility that an individual becomes an alcoholic abuser. We think that if this data are confirmed in a wider study, some guidelines for the prevention of alcoholic cirrhosis may be established.

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The aim of this work is to establish the best treatment for patients with gastric and duodenal ulcer, by measuring the effects of antiacids and H2-receptor antagonists on gastric pH. 16 patients were studied: 9 of them had a duodenal ulcer, 2 a gastric ulcer and 5 had both. All the patients remained fasting and receiving no drug for 24 hrs. During this 24 hrs., a nasogastric tube was inserted into the stomach and the gastric content was obtained by aspiration each hour from 8 A.M. to 8 P.M. Three days after, each patient received a daily dose of 1 g of Cimetidine, and the whole procedure was repeated. The same was done with 300 mg of Ranitidine daily, 150 ml of Al-Mg antiacids daily, and at last, the same procedure was performed with the association of Ranitidine and Al-Mg antiacids at the mentioned dosage. For the statistical analysis of the data, the mean ordinate of the pH was used as a representative value of each individual's pH. Individual differences (pH with treatment minus pH without treatment) were obtained. The mean effect of each treatment was obtained averaging that differences. For comparison among different drugs, the same procedure was used. Student's paired t tests were performed in a signification level. The buffering capacity was measured in the following way: The percentage of the gastric secretion samples with pH equal or higher than 4 in each treatment and in the total number of patients was confronted with the results obtained in the same patients with no treatment. All the drugs were useful for buffering the gastric acidity, but in different intensity. The association of Ranitidine and Al-Mg antiacids showed to be the most efficient statistically when compared with Cimetidine and Al-Mg antiacids; no statistical difference appeared in the comparison with Ranitidine.

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The existence of a relationship between HLA and the possibility of the development of an alcoholic cirrhosis is researched in this paper. This work was done from 1982 to 1984, by the staff of four clinics of the Medicine School of the University of Uruguay. We studied 47 alcoholics with portal cirrhosis, 19 non-cirrhotic alcoholics and 250 healthy nonalcoholic controls. We confirmed with liver biopsy the cirrhosis in the first group and in the second, liver biopsy was performed in order to assure that they had no cirrhosis. Table I shows the histocompatibility antigens which were tested in the 3 groups. Levels of significance were obtained from exact Fisher test with Yates correction for discontinuity; Pc (corrected P) and RR (relative risk) were also determined. In the alcoholics with portal cirrhosis, the HLABW40 showed a Pc less than 0,005 (RR = 3,93). In the non-cirrhotic alcoholics no significative association was found. We conclude that the carrier of the genetic marker HLABW40, has almost 4 times more chances to develop a cirrhosis as consequence of chronic alcoholic abuse. The presence of this marker, in our patients, has no association with the possibility that an individual becomes an alcoholic abuser. We think that if this data are confirmed in a wider study, some guidelines for the prevention of alcoholic cirrhosis may be established.

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The aim of this work is to establish the best treatment for patients with gastric and duodenal ulcer, by measuring the effects of antiacids and H2-receptor antagonists on gastric pH. 16 patients were studied: 9 of them had a duodenal ulcer, 2 a gastric ulcer and 5 had both. All the patients remained fasting and receiving no drug for 24 hrs. During this 24 hrs., a nasogastric tube was inserted into the stomach and the gastric content was obtained by aspiration each hour from 8 A.M. to 8 P.M. Three days after, each patient received a daily dose of 1 g of Cimetidine, and the whole procedure was repeated. The same was done with 300 mg of Ranitidine daily, 150 ml of Al-Mg antiacids daily, and at last, the same procedure was performed with the association of Ranitidine and Al-Mg antiacids at the mentioned dosage. For the statistical analysis of the data, the mean ordinate of the pH was used as a representative value of each individuals pH. Individual differences (pH with treatment minus pH without treatment) were obtained. The mean effect of each treatment was obtained averaging that differences. For comparison among different drugs, the same procedure was used. Students paired t tests were performed in a signification level. The buffering capacity was measured in the following way: The percentage of the gastric secretion samples with pH equal or higher than 4 in each treatment and in the total number of patients was confronted with the results obtained in the same patients with no treatment. All the drugs were useful for buffering the gastric acidity, but in different intensity. The association of Ranitidine and Al-Mg antiacids showed to be the most efficient statistically when compared with Cimetidine and Al-Mg antiacids; no statistical difference appeared in the comparison with Ranitidine.

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